Lung cancer remains the primary cause of
cancer-related mortality worldwide. Several treatment modalities are available for
lung cancer, including surgery, radiation, and
chemotherapy. Among the chemotherapeutics available,
afatinib has been shown to be effective for those with
epidermal growth factor receptor (EGFR) mutation-positive
lung adenocarcinoma. Herein, we analyzed the factors affecting the prognosis of patients who received
afatinib as a first-line
therapy for advanced EGFR mutation-positive
lung adenocarcinoma in the real-world setting. Patients who received
afatinib as a first-line
therapy and were reimbursed by the National Health Insurance were recruited in this study. Data on patient characteristics and treatment courses were collected. In total, 259 patients were enrolled (median follow-up, 22.0 months). Of them, 82 (31.7%) were identified to have
brain metastases at baseline, which were associated with poor Eastern Cooperative Oncology Group performance status, high incidence of central nervous system progression, and short overall survival. However, the results of our analysis showed that overall survival was not affected by reductions in the
afatinib dosage or any upfront local treatments for
brain tumors. Multivariate analyses showed that
brain metastases at diagnosis and treatment response to
afatinib are two important prognostic factors for the overall survival of patients with EGFR mutation-positive
lung adenocarcinoma.